Individual
MR. ROSS EDWIN MALKUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
301 BECKER AVE SW, WILLMAR, MN 56201-3302
(320) 235-4543
Mailing address
10050 67TH AVE NW, PENNOCK, MN 56279-9788
(320) 599-4207
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R092898-8
MN
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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